13. Customer service

13. Customer

service

13-1: Overview

Role in

quality

management

system

This chapter will describe basic

elements that are essential for

developing an effective customer

service programme.

Customer

satisfaction

is

a

major component of a quality

management system, and a significant

focus in the International Organization

for Standardization (ISO) standards.

Ultimately, the laboratory produces

a product��the test result��for its

customers. If the customer is not

well served, the laboratory is not

achieving its primary function.

Overview

of the

process

Organization

Personnel

Equipment

Purchasing

and

inventory

Process

control

Information

management

Documents

and

records

Occurrence

management

Assessment

Process

improvement

Customer

service

Facilities

and

safety

Philip Crosby defined quality practice as meeting the requirements of the

customer. He applied this practice to business and manufacturing, but it is

equally important for a medical laboratory. The medical laboratory needs to

know who its clients are, and understand clients�� needs and requirements.

Medical laboratories have a range of customers including patients, physicians,

public health agencies and the community.

Laboratory

responsibilities

It is the responsibility of the laboratory director to ensure that the customers��

needs are met, and that there is customer satisfaction. The quality manager is

responsible for measuring the degree of customer satisfaction, using surveys,

indicators and audits to take preventive and corrective action.

All laboratory staff must understand the importance of customer satisfaction.

Laboratory personnel must always interact with customers in a way that is

appropriate, providing needed information, and being courteous.

150

Laboratory Quality Management System

13-1: Overview

Establishing a

programme to

address customer

satisfaction

Seeking customer satisfaction requires the following:

1. Commitment��customer satisfaction is a requirement of several international

standards for laboratory quality, but some laboratory staff might consider it

secondary to technical competency. Because of the importance of customer

satisfaction in a quality system, all staff must be strongly committed to the

process.

2. Planning��monitoring takes time and planning to be done properly.Appropriate

monitoring tools need to be developed prior to gathering information. Poor

planning results in inadequate information and often leads to uninterpretable

information.

3. Knowledge��creation of useful monitoring tools requires specific knowledge.

If there are not people in the laboratory that have that knowledge, the

laboratory may consider sending staff for special training or hiring a consultant.

4. Resources��the process to monitoring does not have to be heavily resourced,

but it does take time. Some of that time can be saved by having access to

calculators, computers and the internet.

Laboratory Quality Management System

151

13-2: The laboratory clients��the customers

The laboratory

and its clients

The laboratory has many clients and the needs of all must be carefully addressed.

A central figure in the client list is the physician or health care provider. The

initial request for service originates with this person, and the laboratory staff

generally identifies the ordering physician as the primary client. Remember that in

a hospital setting, the health care provider will be assisted by many other people,

including nurses, medical assistants, phlebotomists, and secretaries or

clerks. These vital hospital personnel should also be considered clients of the

laboratory, and their needs must be considered.

Another important client for the laboratory is the patient, usually including their

family. Family members may play a very important role in patient management,

and may help with sample collection and transport.

When laboratory testing is being performed to meet a public health need, public

health officials or workers become clients of the laboratory.The laboratory is a

critical partner in surveillance, disease detection and prevention, and other public

health programmes. Laboratories need to meet the needs of the public health

workers in addressing problems. They sometimes need to share information

without compromising the confidentiality of the patient. Specialized laboratories

such as food safety or water testing laboratories would have other customers

to consider, such as food producers, manufacturers, or water systems

managers.

The community in which a laboratory works also has expectations. The

community needs to be assured that the laboratory will not create a risk for

workers, visitors or the public.

In many countries, laboratory tests can only be ordered by a licensed

health care provider��a physician, nurse or dentist. In some countries,

laboratory tests can be ordered by the patient directly without referral from a

physician or nurse. Some patients do not have the knowledge or expertise to

order the right test or to interpret results. Laboratory personnel may have to

provide assistance in test selection and interpretation.

Legal

identity

152

International standards usually require that any laboratory clearly identifies itself

to the public, giving assurance that an identified person is in charge and accessible.

At a minimum, every laboratory must make public a laboratory name and address,

and the name of the director, including relevant contact information.

Laboratory Quality Management System

13-2: The laboratory clients��the customers

Physician or

health care

provider

requirements

The health care provider expects to have access to accurate, clinically relevant

information that can be understood and used in a timely manner. Health care

professionals need assurance of laboratory responsibility throughout the testing

process, including pre-examination steps, the testing process itself and the postexamination process.

In the re-examination phase, physicians will be particularly interested in the test

menu. They benefit from an accurate collection manual, requisition forms that are

complete but user friendly, and a timely delivery system.

For the testing or examination phase, physicians would like to be sure of working

with competent personnel. They need to know that the test methods being used

have been validated, and that testing is done with good process control and

with quality control procedures in place. Appropriate management of all adverse

occurrences or errors will significantly affect physician laboratory use.

Patient

requirements

The physician looks to the laboratory to do an excellent job in managing the

post-examination steps, as these are critical to receiving the results of testing.

A solid laboratory information system, a method for results verification, and for

delivering timely and interpretable results to the right place, are all important.

The patient expects to receive personal care, keeping in mind comfort and privacy.

He or she also expects to be assured that the testing has been done correctly and

properly, and provided to the health care provider in a timely manner.

The laboratory actions needed to meet the patient requirements include:

? providing adequate information, both for collection of a specimen, and also

information about the laboratory;

? providing good collection facilities;

? having available trained and knowledgeable personnel��personnel should know

how to collect a sample properly, and should be trained to be courteous to all

patients;

? giving assurance that the laboratory records are maintained properly so that

they can be easily retrieved, and also giving assurance of protection of the

confidentiality of the records.

Public health

requirements

Public health professionals have the same needs as health care providers, requiring

that all parts of the pre-examination, examination and post-examination processes

are carried out properly. They may need special kinds of information in dealing

with an outbreak or epidemic, such as specific collection processes or forms

designed for the particular project or investigation. Public health officials will

also be particularly concerned with safety issues and containment of infectious

material.

Food manufacturers and producers, and water plant managers will need

information from the laboratory to help them comply with their specific quality

requirements.

Laboratory Quality Management System

153

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